1 Table of contents 40

2020-2021 Benefits Guide

Table of Contents		2
City of Pearland Holiday Calendar		3
Thanksgiving Holidays Thursday, November 26, 2020		3
Take Care of Your Tomorrow!		4
Benefits Resource List		5
Registering and Enrolling on Benefit Connector		6
Online Enrollment Instructions		7
Eligiblity		8
Medical Benefits		9
Wellness Instructions		10
Wellness Instructions – Form		11
Generic Drugs: Questions and Answers		12
OneRx		13
Health Savings Account (HSA)		14
WHAT IS A HEALTH SAVINGS ACCOUNT (HSA)?		14
WHAT IS A HIGH DEDUCTIBLE HEALTH PLAN (HDHP)?		14
Health Savings Account (HSA) continued		15
HSA ADVANTAGES AND HOW DOES THE HSA PLAN WORK?		15
Urgent Care vs. Emergency Rooms		16
Surprise Medical Bills		17
I GOT A SURPRISE BILL. WHAT CAN I DO ABOUT IT?		17
Dental Benefits		18
Vision Benefits		19
Basic Life & AD&D Benefits		20
How Much Life Insurance Do You Need?		21
Voluntary Life & AD&D Benefits		22
Disability Insurance		23
Employee Assistance Program (EAP)		24
Flexible Spending Account		25
Limited Flexible Spending Account		26
Medical Eligible Expenses for HSA or FSA		27
Aflac Short Term Disability/Whole Life Insurance		28
Aflac Group Whole Life		28
Aflac Accident Plan/Hospital Indemnity Plan		29
Aflac Critical Illness Plan		30
Aflac Enrollment & Claim Filing		31
Aflac group enrollees now have a faster, easier option for filing claims for critical illness, hospital indemnity, accident policies and wellness benefits. To begin the claim process, participants can simply visit AflacGroupInsurance.com to submit th...		31
You can contact Aflac directly at 1-800-433-3036		31
LegalShield		32
IDShield		33
Gym Membership		34
What Constitutes a Qualifying Life Event?		35
Glossary of Health Coverage & Medical Terms		36
Allowed Amount		36
Appeal		36
Balance Billing		36
Co-insurance		36
Complications of Pregnancy		36
Co-payment		36
Deductible		36
Durable Medical Equipment (DME)		36
Emergency Medical Condition		36
Emergency Medical Transportation		36
Emergency Room Care		36
Emergency Services		36
Glossary of Health Coverage & Medical Terms (continued)		37
Excluded Services		37
Grievance		37
Habilitation Services		37
Health Insurance		37
Home Health Care		37
Hospice Services		37
Hospitalization		37
Hospital Outpatient Care		37
In-network Co-insurance		37
In-network Co-payment		37
Medically Necessary		37
Network		37
Non-Preferred Provider		37
Out-of-network Co-insurance		37
Out-of-network Co-payment		37
Glossary of Health Coverage & Medical Terms (continued)		38
Out-of-Pocket Limit		38
Physician Services		38
Plan		38
Preauthorization		38
Preferred Provider		38
Premium		38
Prescription Drug Coverage		38
Prescription Drugs		38
Primary Care Physician		38
Primary Care Provider		38
Provider		38
Reconstructive Surgery		38
Glossary of Health Coverage & Medical Terms (continued)		39
Rehabilitation Services		39
Skilled Nursing Care		39
Specialist		39
UCR (Usual, Customary and Reasonable)		39
Urgent Care		39

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